HRD effects on first-line adjuvant chemotherapy and PARPi maintenance therapy in Chinese ovarian cancer patients

Homologous recombination deficiency (HRD) testing has been approved by FDA for selecting epithelial ovarian cancer (EOC) patients who may benefit from the first-line poly (ADP-ribose) polymerase inhibitor (PARPi) maintenance therapy. However, the effects of HRD on the clinical outcomes of first-line chemotherapy and first-line PARPi maintenance therapy have not been rigorously evaluated in Chinese EOC patients. Here, we developed an HRD assay and applied it to two large retrospectively collected Chinese EOC patient cohorts. In the first-line adjuvant chemotherapy cohort (FACT, N = 380), HRD status significantly improved PFS (median, 15.6 months vs. 9.4 months; HR, 0.688; 95% CI, 0.526-0.899; P = 0.003) and OS (median, 89.5 months vs. 60.9 months; HR, 0.636; 95% CI, 0.423-0.955; P = 0.008). In the first-line PARPi maintenance therapy cohort (FPMT, N = 83), HRD status significantly improved PFS (median, NA vs. 12 months; HR, 0.438; 95% CI, 0.201-0.957; P = 0.033) and OS (median, NA vs. NA months; HR, 0.12; 95% CI, 0.029-0.505; P = 0.001). Our results demonstrate that HRD status is a significant predictor for PFS and OS in both first-line chemotherapy and first-line PARPi maintenance therapy, providing strong real-world evidence for conducting genetic testing and improving clinical recommendations for Chinese EOC patients.

Isolation and characterization of a lipopeptide-producing Bacillus sp. strain JK08 with antagonistic activity against Vibrio parahaemolyticus

AIMS

The present study aimed to isolate a potential antagonist Bacillus sp. and evaluate its capacity for controlling pathogenic Vibrio parahaemolyticus in aquaculture.

METHODS AND RESULTS

Strain JK08, which showed inhibitory activity against V. parahaemolyticus VP02r, was isolated from a Penaeus vannamei pond. Based on morphological, physiological, and biochemical characteristics and phylogenetic analysis, strain JK08 was identified as Bacillus sp. Through culture condition optimization, the maximal inhibition zone diameter (18.19 ± 0.16 mm) was observed when strain JK08 was cultivated at a temperature of 30°C, pH of 7, and salinity of 20‰ in Luria-Bertani broth for 24 h. The inhibition zone against V. parahaemolyticus VP02r of strain JK08 (approximately 7 μg, in mass of crude antimicrobial substance, per tablet) was larger than those (14-18 mm in diameter) of several commercial antibiotics (10 μg per tablet) in the in vitro antagonism assay. Liquid chromatography-tandem mass spectrometry analysis results indicated the presence of three families of lipopeptides in the antimicrobial substance: surfactin (C12-C17), iturin A (C14-C17), and fengycin A (C14-C17) and B (C17), which might be the key components contributing to the antagonistic activity of Bacillus sp. strain JK08.

CONCLUSIONS

Strain JK08, which is capable of producing antibacterial lipopeptides, shows effective antagonistic activity against V. parahaemolyticus VP02r, implying its promising potential for V. parahaemolyticus control in aquaculture.

Noninvasive detection of chromosomal instability in plasma circulating cell-free DNA for early pan-cancer diagnosis using low-pass whole-genome sequencing

e22509

Background: Genomic instability is a typical characteristic of the majority of cancers. Early non-invasive detection of cancer is the most effective way of improving the success of treatment and prognosis at present. Traditional tumor screening methods have limitations in terms of selection methods, sensitivity, specificity, cost, and comfortability. Furthermore, although traditional tumor screening is useful for common cancers, there is no available screening test for rare cancers. Here we developed a novel method for cancer detection with Low-Pass Whole Genome Sequencing (WGS) of cell-free DNA (cfDNA). Methods: The cfDNA samples from 52 healthy donors were first used to establish a blacklist of bins. Then the baseline was established to calculate the chromosomal instability score (CINscore). We optimized the parameters of our model using the following discovery datasets: healthy controls (n = 50), breast invasive carcinoma (BRCA) (n = 44), ovarian serous cystadenocarcinoma (OV) (n = 25), colon adenocarcinoma/rectum adenocarcinoma esophageal carcinoma (COREAD) (n = 52), hepatocellular carcinoma (HCC) (n = 43), Gastric adenocarcinoma (GAC) (n = 31); pancreatic adenocarcinoma (PAC) (n = 38), non-small cell lung cancer (NSCLC) (n = 45). Results: We further evaluated the performance of our method using the confirmation datasets of healthy controls (n = 30), BRCA (n = 20), prostate adenocarcinoma (PRAD) (n = 6), OV (n = 7), head and Neck squamous cell carcinoma (HNSC) (n = 10), Uterine Corpus Endometrial Carcinoma (UCEC) (n = 6), cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) (n = 5), COREAD (n = 75), HCC (n = 50), GAC (n = 31), cholangiocarcinoma (CHOL) (n = 8), PAC (n = 10), NSCLC (n = 98), esophageal carcinoma (ESCA) (n = 10), and nasopharyngeal carcinoma (NAC) (n = 4). Overall, the area under the curve (AUC) for pan-cancer is 88.7%, and for BRCA, COREAD, HCC, NSCLC, and GAC are 91.7%, 90.0%, 94.5%, 83.4%, and 88.6%, respectively. Moreover, our approach achieved good performance on the the early stage samples of pan-cancer (AUC = 84.3%) as well as COREAD (AUC = 89.3%) and NSCLC (AUC = 79.0%). Conclusions: Collectively, we show that the CINscore inferred from low-pass WGS could be applied in early non-invasive detection of different cancers with high accuracy. Our approach may aid the improvement of the cancer diagnosis.

Protective mechanical ventilation with optimal PEEP during RARP improves oxygenation and pulmonary indexes

BACKGROUND

This trial aimed to evaluate the effects of a protective ventilation strategy on oxygenation/pulmonary indexes in patients undergoing robot-assisted radical prostatectomy (RARP) in the steep Trendelenburg position.

METHODS

In phase 1, the most optimal positive end-expiratory pressure (PEEP) was determined in 25 patients at 11 cmH₂O. In phase 2, 64 patients were randomized to the traditional ventilation group with tidal volume (VT) of 9 ml/kg of predicted body weight (PBW) and the protective ventilation group with VT of 7 ml/kg of PBW with optimal PEEP and recruitment maneuvers (RMs). The primary endpoint was the intraoperative and postoperative PaO₂/FiO₂. The secondary endpoints were the PaCO₂, SpO₂, modified clinical pulmonary infection score (mCPIS), and the rate of complications in the postoperative period.

RESULTS

Compared with controls, PaO₂/FiO₂ in the protective group increased after the second RM (P=0.018), and the difference remained until postoperative day 3 (P=0.043). PaCO₂ showed transient accumulation in the protective group after the first RM (T2), but this phenomenon disappeared with time. SpO₂ in the protective group was significantly higher during the first three postoperative days. Lung compliance was significantly improved after the second RM in the protective group (P=0.025). The mCPIS was lower in the protective group on postoperative day 3 (0.59 (1.09) vs. 1.46 (1.27), P=0.010).

CONCLUSION

A protective ventilation strategy with lower VT combined with optimal PEEP and RMs could improve oxygenation and reduce mCPIS in patients undergoing RARP.

TRIAL REGISTRATION

ChiCTR ChiCTR1800015626 . Registered on 12 April 2018.

Dosimetric effects of supine immobilization devices on the skin in intensity-modulated radiation therapy for breast cancer: a retrospective study

Background

The dose perturbation effect of immobilization devices is often overlooked in intensity-modulated radiation therapy (IMRT) for breast cancer (BC). This retrospective study assessed the dosimetric effects of supine immobilization devices on the skin using a commercial treatment planning system.

Methods

Forty women with BC were divided into four groups according to the type of primary surgery: groups A and B included patients with left and right BC, respectively, who received 50 Gy radiotherapy in 25 fractions after radical mastectomy, while groups C and D included patients with left and right BC, respectively, who received breast-conservation surgery (BCS) and 40.05 Gy in 15 fractions as well as a tumor bed simultaneous integrated boost to 45 Gy. A 0.2-cm thick skin contour and two sets of body contours were outlined for each patient. Dose calculations were conducted for the two sets of contours using the same plan. The dose differences were assessed by comparing the dose-volume histogram parameter results and by plan subtraction.

Results

The supine immobilization devices for BC resulted in significantly increased skin doses, which may ultimately lead to skin toxicity. The mean dose increased by approximately 0.5 and 0.45 Gy in groups A and B after radical mastectomy and by 2.7 and 3.25 Gy in groups C and D after BCS; in groups A–D, the percentages of total normal skin volume receiving equal to or greater than 5 Gy (V₅) increased by 0.54, 1.15, 2.67, and 1.94%, respectively, while the V₁₀ increased by 1.27, 1.83, 1.36, and 2.88%; the V₂₀ by 0.85, 1.87, 2.76, and 4.86%; the V₃₀ by 1.3, 1.24, 10.58, and 11.91%; and the V₄₀ by 1.29, 0.65, 10, and 10.51%. The dose encompassing the planning target volume and other organs at risk, showed little distinction between IMRT plans without and with consideration of immobilization devices.

Conclusions

The supine immobilization devices significantly increased the dose to the skin, especially for patients with BCS. Thus, immobilization devices should be included in the external contour to account for dose attenuation and skin dose increment.

Trial registration

This study does not report on interventions in human health care.

[Analysis on the use of radiation protective equipment for the accompanying examinees]

Objective: To investigate the situation of wearing protective equipment in the process of X-ray radiation examination (including DR and CT) in a 3A general hospital, so as to provide technical basis and solutions for better reducing the radiation dose of accompanying patients. Methods: From November 1, 2018 to June 30, 2019, the accompanying examinee 6 who had to stay in the examination room during the radiology examination (X-ray and CT examination) of a 3A general hospital from June 1, 2018 to June 30, 2019 was selected 535 people were divided into three groups according to whether they were reminded and instructed to wear protective equipment: group A was not reminded (group A) , group B was reminded to wear protective equipment, and group C was reminded and instructed to wear protective equipment (Group C) . Results: The wearing rates of protective equipment of the three groups were 35.0% (744/2126) , 85.2% (1858/2181) and 91.0% (2028/228) , and the complete wearing rates were 15.0% (319/2126) , 54.8% (1195/2181) and 88.0% (1960/228) , respectively. 4% (1450/3060) , 28.6% (876/3060) , 24.0% (734/3060) , respectively. 523 patients refused to wear protective equipment. The main reasons were emotion (33.8%, 177/523) and time (32.5%, 170/523) . Conclusion: The intervention of radiation workers can effectively improve the correct wearing rate of protective equipment and reduce the radiation exposure of accompanying people.

Regulatory mechanism of TGF-β1/SGK1 pathway in tubulointerstitial fibrosis of diabetic nephropathy

OBJECTIVE

The aim of this study was to clarify the potential function of transforming growth factor-β1/serum/glucocorticoid-regulated kinase 1 (TGF-β1/SGK1) pathway in diabetic nephropathy-induced tubulointerstitial fibrosis.

MATERIALS AND METHODS

Type 2 diabetes mellitus (T2DM) model was successfully established in rats by high-sucrose-high-fat diet combined with streptozotocin (STZ) induction. Subsequently, blood glucose level, renal function and pathological changes in kidneys of T2DM and control rats were evaluated. Western blot and quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) were conducted to determine the protein and mRNA expression levels of TGF-β1, SGK1, fibronectin (FN) and α-smooth muscle actin (α-SMA) in rat kidney tissues, respectively.

RESULTS

Blood glucose (BG), glycosylated hemoglobin (GHb), serum creatinine (Scr) and blood urea nitrogen (BUN) in T2DM rats were significantly higher than those of control rats (p<0.05). The morphology of glomeruli and renal tubules in rats of control group were normal. In contrast, T2DM rats showed significant lesions in glomeruli, renal tubules, and renal interstitium. Furthermore, the relative expression levels of TGF-β1, SGK1, FN, and α-SMA in kidney tissues of T2DM rats were remarkably higher than those of controls (p<0.05).

CONCLUSIONS

The TGF-β1/SGK1 pathway is closely related to tubulointerstitial fibrosis in T2DM rats.

A Novel Nitrite-Base Aerobic Denitrifying Bacterium Acinetobacter sp. YT03 and Its Transcriptome Analysis

Nitrite in a water environment is very harmful to humans and aquatic animals. A novel aerobic denitrifying bacterium able to utilize NO2--N as the only nitrogen source was isolated for the purpose of removing nitrite from water, which was identified as Acinetobacter sp. and named as YT03. The growth and denitrification activity of strain YT03 was assessed comprehensively. Results showed that the nitrite in water with an initial concentration of 10 mg L^–1 could be completely removed within 6 h by strain YT03, and the optimal conditions for strain YT03 to remove nitrite were as follows: sodium succinate as the carbon source, C/N ratio of 16, pH of 6.5, temperature of 30°C, and shaking speed of 250 rpm. An RNA-Seq transcriptome analysis was used to find genes associated with nitrite removal. Compared with the removal of ammonia nitrogen, 47 genes were significantly differentially expressed, including 20 up-regulated and 27 down-regulated genes, mainly involved in the transport process, biosynthetic process, and so on. And among the differentially expressed genes, C4-dicarboxylate transporter (DctA) and nitrate/nitrite transporter (Nrt) might be of importance for the efficient utilization of carbon and nitrogen sources in aerobic nitrite denitrification with sodium succinate by strain YT03.

Effect of intraoperative lung-protective mechanical ventilation on pulmonary oxygenation function and postoperative pulmonary complications after laparoscopic radical gastrectomy

This study aimed to observe the effects of lung-protective ventilation (LPV) on oxygenation index (OI) and postoperative pulmonary complications (PPCs) after laparoscopic radical gastrectomy in middle-aged and elderly patients. A total of 120 patients who were scheduled to undergo laparoscopic radical gastrectomy with an expected time of >3 h were randomly divided into conventional ventilation (CV group) with tidal volume (TV) of 10 mL/kg without positive end-expiratory pressure (PEEP), and lung-protective ventilation (PV group) with 7 mL/kg TV and personal level of PEEP with regular recruitment maneuver every 30 min. Measurements of OI, modified clinical pulmonary infection score (mCPIS), and PPCs were assessed during the perioperative period. Fifty-seven patients in the CV group and 58 in the PV group participated in the data analysis. Patients in the PV group showed better pulmonary dynamic compliance, OI, and peripheral capillary oxygen saturation during and after surgery. The mCPIS was significantly lower in the PV group than in the CV group after surgery. The incidence rate of PPCs was lower in the PV group than in the CV group and the difference was significant in patients whose ventilation time was longer than 6 h in both groups. LPV during laparoscopic radical gastrectomy significantly improved pulmonary oxygenation function and reduced postoperative mCPIS and the incidence of PPCs during the early period after surgery of middle-aged and elderly patients, especially patients whose mechanical ventilation time was longer than 6 h.

Team Autonomy Amplifies the Positive Effects of Proactive Personality on Work Engagement

From the perspective of the interaction of person and situation, we examined the effects of proactive personality on inrole performance investment and extrarole behavior of employees, and how these effects are amplified by situational conditions. Specifically, we investigated the effects of proactive personality on employees’ work engagement and altruism, and the moderating effect of team-level autonomy on these effects. Data were collected from 464 nurses and their supervisors in 75 teams at 4 hospitals in Shandong, China. Results suggest that proactive personality is positively related to work engagement and altruism of employees. The positive relationship between proactive personality and work engagement is stronger with a higher level of team autonomy, whereas the positive relationship between proactive personality and altruism is not significantly moderated by degree of team autonomy. Theoretical and practical implications are discussed.

Ectopic Cartilage Formation Induced by Mesenchymal Stem Cells on Porous Gelatin-Chondroitin-Hyaluronate Scaffold Containing Microspheres Loaded with TGF-β1

The study aimed to produce a novel porous gelatin-chondroitin-hyaluronate scaffold in combination with a controlled release of TGF-β1 and to evaluate its potentials in ectopic cartilage formation. The gelatin-chondroitin-hyaluronate scaffold was developed to mimic the natural extra cellular matrix of cartilage. Gelatin microspheres loaded with TGF-β1 (MS-TGFβ1) showed a fast cytokine release at initial phase (37.4%) and the ultimate accumulated release was 83.1% by day 18. Then MS-TGFβ1 were incorporated into scaffold. The MSCs seeded on scaffold with or without MS-TGFβ1 were incubated in vitro or implanted subcutaneously in nude mice. In vitro study showed that, compared to the scaffold, the scaffold/MS-TGFβ1 significantly augmented the proliferation of MSCs and GAG synthesis. Three weeks postoperatively histology observation showed that in MSCs/scaffold/MS-TGFβ1 implantation group, cells of newly formed ectopic cartilage were located within typical lacunae and demonstrated morphological characteristics of chondrocytes. Six weeks later the ectopic cartilage grew more and islands of cartilage were observed. The matrix was extensively metachromatic by safranin-O/Fast green staining. Immunohistochemical staining also indicated ectopic cartilage was intensely stained for type II collagen. Instead, in the MSCs/scaffold implantation group, no cartilage-like tissue formed and matrix showed negative or weak positive staining. The percentage of positive staining area was significantly larger in MSCs/scaffold/MS-TGFβ1 group (p<0.05) at each time point. The results indicated that the novel gelatin-chondroitin-hyaluronate scaffold with MS-TGFβ1 could induce the chondral differentiation of MSCs to form cartilage and might serve as a new way to repair cartilage defects.

Highly stable Y(iii)-based metal organic framework with two molecular building block for selective adsorption of C2H2 and CO2 over CH4

A novel microporous MOF ZJU-16 exhibited high thermal and chemical stability and moderately high selective separation of C₂H₂/CH₄ and CO₂/CH₄.

Regulation of M1‑type and M2‑type macrophage polarization in RAW264.7 cells by Galectin‑9

Generally considered as a potent pro‑inflammatory signal, β‑galactosidelectin suppresses T cell receptor activation, can both promote and inhibit integrin‑mediated adhesion and is required in nuclear pre‑mRNA splicing. Galectin‑9 (Gal‑9), a member of β‑galactoside lectin, is involved many processes of T cell‑mediated diseases (such as autoimmune diseases and asthma) and immunomodulation of macrophages. Macrophages are involved in the occurrence of inflammation, development and digestion and other stages. At different stages of the inflammatory response, macrophages exhibit different phenotypes, but mainly two subtypes, classically (M1) or alternatively (M2) polarization. The purpose of this work is to investigate the effect of overexpression or knockdown of Gal‑9 on the macrophage polarization. Macrophage polarization was detected by flow cytometric profiling of secreted cytokines and specific surface markers expression, including nitric oxide synthase 2 (NOS2) and mannose receptor 1 (CD206). Protein and mRNA expression levels of TNF‑α, TGF‑β, IL‑6, IL‑10, NF‑κB, signal transducer and activator of transcription (Stat)1 and Stat3 were determined by ELISA, western blot analysis or qRT‑PCR. Our results implied that differentiation of the mouse macrophage line RAW264.7 into M1‑type and M2‑type macrophages is followed by marked variations of Gal‑9 expression. Furthermore, its overexpression and secretion are tightly associated with M2‑type macrophages, whereas its downregulation promotes macrophages to polarize into M1‑type macrophages, which confirmed by elevated CD206 and NOS2, respectively. In response to the changes of Gal‑9 expression, cytokines, transcription factors and regulators, including TNF‑α, IL‑6, NF‑κB, Stat1, TGF‑β, IL‑10, and Stat3, were tightly regulated and significantly associated with classically and alternatively activated macrophages. Consistent with characteristics of M1‑type macrophages, the transcriptional or translational expression levels or activity of TNF‑α, IL‑6, Stat1 and NF‑κB were markedly increased with knockdown of Gal‑9 in macrophages. By contrast, the expression levels or activity of TGF‑β, IL‑10 and Stat3 were clearly elevated in macrophages with Gal‑9 overexpression, which is closely related with M2‑type macrophages. Specific expression and secretion patterns of cytokines, transcription factors and regulators in M1‑type and M2‑type macrophages contribute to better understanding the role of Gal‑9 in regulation in macrophages. This study provides a new insight that Gal‑9 may be a new immunomodulatory target for macrophages.

A correlation analysis between tumor imaging changes and p-AKT and HSP70 expression in tumor cells after osteosarcoma chemotherapy

This study sought to investigate osteosarcoma property changes after neoadjuvant chemotherapy and to analyze any correlation between changes with phospho-AKT (p-AKT) and heat shock protein 70 (HSP70) expression in osteosarcoma cells. Thirty patients with osteosarcoma treated at Liaocheng People's Hospital between January and October, 2016 were given an imaging examination before and after neoadjuvant chemotherapy to examine osteosarcoma tumor properties, with images scored. Immunohistochemistry was used to determine p-AKT and HSP70 expression levels, as well as tumor cell necrosis rate (TCNR), in specimens obtained before and after chemotherapy. The correlation between the imaging changes of osteosarcoma after chemotherapy and the expressions of p-AKT and HSP70 in tumor cells. Compared with pre-chemotherapy, the imaging scores of the 30 patients significantly increased after chemotherapy (P<0.05). The radiographic score of the TCNR ≥90% group was 11.3±0.5, which was significantly higher than that of the TCNR <90% group (8.7±0.3, P<0.05). p-AKT expression in osteosarcoma cells was found in 13.3% of samples (4/30 cases) after chemotherapy, which was significantly lower than prior to chemotherapy (73.3%, 22/30 cases, P<0.05). After chemotherapy, HSP70 expression in osteosarcoma cells was found in 6.7% of samples (2/30 cases), which was significantly lower than prior to chemotherapy (83.3%, 25/30 cases, P<0.05). p-AKT and HSP70 expression levels were found to be correlated with TCNR after chemotherapy (P<0.05). After chemotherapy, p-AKT and HSP70 expression levels demonstrated a positive correlation with TCNR. Tumor property changes, as uncovered by imaging, were significantly inversely correlated with tumor cell p-AKT and HSP70 expression after chemotherapy. Therefore, osteosarcoma properties, as determined through X-ray imaging, were closely related to p-AKT and HSP70 expression in osteosarcoma cells after neoadjuvant chemotherapy. The effect of chemotherapy can be evaluated by observing the above examination results.

IL-33 Attenuates Sepsis by Inhibiting IL-17 Receptor Signaling through Upregulation of SOCS3

BACKGROUND/AIMS

Sepsis is a systemic inflammatory response during infection. There are limited therapeutic options for sepsis patients. Interleukin (IL)-33 has been reported recently with a beneficial effect in mouse sepsis.

METHODS

In this study, we initiated a clinical study to measure serum levels of pro-inflammatory cytokines including IL-33 in sepsis patients. Next, we employed cecal ligation and puncture (CLP) to study the role of IL-33 during sepsis. To further dissect the molecular mechanism, we used in vivo knockout models and in vitro knockdown murine embryonic fibroblasts (MEFs) to investigate the cross-talk between IL-33 and IL-17 signaling, and to identify the potential downstream mediators.

RESULTS

IL-33 and IL-17 were upregulated in both clinical and experimental sepsis. In CLP, IL-33 (-/-) mice showed higher mortality rate, and IL-33 treatment improved the survival rate. Elevated proinflammatory cytokines in sepsis were related to IL-17 from γδT cells. IL-33 treatment suppressed production of these cytokines by targeting IL-17 signaling both in vivo and in vitro. Finally, IL-33 was shown to inhibit the IL-17 pathway via activating suppressor of cytokine signaling (SOCS)-3.

CONCLUSION

Collectively, the results suggest that IL-33 plays a negative regulatory role in sepsis progression by inhibiting IL-17 pathway through activating SOCS3. This finding would inspire a new therapeutic strategy for treating sepsis.

Hydroxyethyl Starch Inhibits Intestinal Production of Cytokines and Activation of Transcription Factors in Endotoxaemic Rats

We studied the effect of hydroxyethyl starch (HES) on intestinal production of cytokines and activation of transcription factors in sepsis. Septic rats, induced by intraperitoneal lipopolysaccharide (LPS) (5 mg/kg), were treated with intravenous HES (16 ml/kg) or saline (64 ml/kg). Rat ileal tissues were collected at 2 h, 3 h or 6 h after LPS challenge. Levels of tumour necrosis factor alpha (TNF-α), interleukin (IL) 1β, IL-6, IL-8 and IL-10, cytokine mRNAs, activities of nuclear factor kappa-B (NF-κB) and activator protein-1 (AP-1), and the number of ileal myeloperoxidase (MPO)-positive cells were determined for each group. HES significantly reduced the LPS-induced increase in intestinal levels of TNF-α, IL-1β, IL-6, IL-8 and their corresponding mRNAs. HES also decreased the number of MPO-positive cells induced by LPS and inhibited activation of NF-κB and AP-1. The results suggest that in sepsis, HES may down-regulate intestinal pro-inflammatory cytokine production via suppression of NF-κB and AP-1 activation.

Characterization of a new HLA-B allele, B*15:179:02

A novel HLA-B allele, B*15:179:02, has been identified during typing of donors in Anhui province, China.

Neuregulin-1 protects against doxorubicin-induced apoptosis in cardiomyocytes through an Akt-dependent pathway

In previous studies, it has been shown that recombinant human neuregulin-1(rhNRG-1) is capable of improving the survival rate in animal models of doxorubicin (DOX)-induced cardiomyopathy; however, the underlying mechanism of this phenomenon remains unknown. In this study, the role of rhNRG-1 in attenuating doxorubicin-induce apoptosis is confirmed. Neonatal rat ventricular myocytes (NRVMs) were subjected to various treatments, in order to both induce apoptosis and determine the effects of rhNRG-1 on the process. Activation of apoptosis was determined by observing increases in the protein levels of classic apoptosis markers (including cleaved caspase-3, cytochrome c, Bcl-2, BAX and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) staining). The activation of Akt was detected by means of western blot analysis. The study results showed that doxorubicin increased the number of TUNEL positive cells, as well as the protein levels of cleaved caspase-3 and cytochrome c, and reduced the ratio of Bcl-2/Bax. However, all of these effects were markedly antagonized by pretreament with rhNRG-1. It was then further demonstrated that the effects of rhNRG-1 could be blocked by the phosphoinositole-3-kinase inhibitor LY294002, indicating the involvement of the Akt process in mediating the process. RhNRG-1 is a potent inhibitor of doxorubicin-induced apoptosis, which acts through the PI3K-Akt pathway. RhNRG-1 is a novel therapeutic drug which may be effective in preventing further damage from occurring in DOX-induced damaged myocardium.

Systemic lupus erythematosus associated with Moyamoya syndrome: a case report and literature review

Moyamoya syndrome (MMS) is a rare, chronic progressive cerebrovascular occlusive disease that is characterized by a stenosis or occlusion of the bilateral internal carotid arteries and the circle of Willis arteries leading to the development of collateral vessels as visualized by cerebral angiography. We report a case of a 24-year-old woman with nephrotic syndrome whose biopsy showed membranous nephropathy. Ten months after the diagnosis she suffered sudden right hemiplegia and seizure. She was diagnosed with MMS by angiogram seven months ago and received decompressive craniotomy. The patient was admitted to our hospital and a diagnosis of systemic lupus erythematosus (SLE) was made. Glucocorticoids and tacrolimus were used to control the symptoms of SLE. Following one month of immunosuppressant treatment, the patient died of brain hemorrhage. This case alongside another six reviewed cases shows that an underlying cerebrovascular lesion of moyamoya in the vessels of patients with SLE is susceptible to cerebrovascular accidents.

Clinical efficacy of chemotherapy combined with verapamil in metastatic colorectal patients

In order to determine the clinical efficacy and adverse reactions of chemotherapy and verapamil infusion through a target artery to treat colorectal cancer patients with metastasis after failure with previous conventional treatments. Patients with metastatic colon cancer (n = 36) received an infusion of verapamil, interleukin-2, oxaliplatin (or hydroxy camptothecin or irinotecan hydrochloride), fluorouracil and calcium folinate through target artery using the Seldinger puncture technique. From the second day of infusion, the patients were treated with fluorouracil and calcium folinate via systematic intravenous injection for 2-3 days. Efficacy was evaluated after at least two treatment courses. The objective response including complete or partial response was 58.3% in the 36 patients; clinical benefit rate, evaluated by Karnofsky Performance Status score was 91.7%; by weight was 83.3%; by the amount of painkiller consumed was 80.6%. No patient experienced side effects associated with heart function. Post-treatment, the P-R period, Q-T period, QRS, and heart rate were not significantly different than before treatment. Liver function was significantly improved. Side effects of chemotherapy were minor in comparison to those observed with intravenous chemotherapy. Infusion of verapamil and chemotherapy directly into pelvic tumor tissue can increase treatment efficacy and has been shown to be a relatively safe technique.

First Report of Stem Blight of Eleocharis dulcis Caused by Phoma bellidis in China

Eleocharis dulcis is a perennial herbaceous plant in the family Cyperaceae, which is native to China and India where it grows well in moist-to-wet soils. It is commonly used as a fruit or a vegetable. From August 2009 to December 2010, symptoms were observed on E. dulcis stems in Tuanfeng County, Hubei, China, with the crop area affected estimated to be more than 1,300 ha per year. Corm yield was reduced by 20% on average with as much as 60% yield losses in some fields. Lesions were initially small, red-brown, and oval or circular that enlarged to produce apical necrosis and extending until the stems withered, usually within 2 months. To obtain isolates, diseased tissue was disinfested for 1 min in 0.1% mercuric chloride solution, rinsed with sterilized water, and plated on potato dextrose agar. Isolates with similar morphological characteristics were consistently recovered. Three isolates, CTF-3, CTF-10, and CTF-11, were used to further evaluate characteristics of the pathogen. After 7 days, white colonies were 76 to 80 mm across on oatmeal agar (OA) with sparse aerial hyphae and a slight salmon color in the conidial masses. Pycnidia produced on OA were globose to subglobose, usually with one slightly ostiolar papilla, olivaceous to olivaceous black, and 93 to 245 μm in diameter. Conidia were hyaline, unicellular, ellipsoidal, mostly with two polar guttules, and 3.6 to 6.2 × 2.0 to 3.3 μm. Chlamydospores were absent. Growth of the isolates on malt extract agar (MEA) was slower than on OA, and the colony diameters at 7 days were 60 to 65 mm. The reactions with 1M NaOH were both positive on OA and MEA where the cultures initially changed to yellow green and gradually turned to red. The pathogen was identified as Phoma bellidis Neerg. based on descriptions in Boerema et al. (2). Pathogenicity tests were performed with the three isolates in the laboratory by spraying conidial suspensions (1 × 10⁶ conidia/ml) containing 0.1% Tween 20 until runoff (30 ml per plant) onto stem surfaces of 50-day-old, 60 cm tall plants. For each isolate, there were 50 stems from five replicate plants that had multiple stems per plant. Control plants were treated with sterilized water containing 0.1% Tween 20 only. Plants were incubated with a 16-h photoperiod at 28°C and 90% relative humidity in an artificial climate chamber. Five days after inoculation, typical red-brown spots were observed on all inoculated stems but no symptoms were seen on water-treated control plants. Koch's postulates were fulfilled by reisolation of P. bellidis from diseased stems. The pathogenicity tests were repeated twice more with the same results. P. bellidis has only been reported previously on Bellis spp. from England, Denmark, Italy, the Netherlands, and Switzerland (1,2). Furthermore, there are only a few fungal diseases known to be associated with E. dulcis, and none so far that involve species of Phoma (3,4). To our knowledge, this is the first report of P. bellidis infecting E. dulcis worldwide. References: (1) M. M. Aveskamp et al. Stud. Mycol. 65:27, 2010. (2) G. H. Boerema et al. Phoma Identification Manual: Differentiation of Specific and Infra-Specific Taxa in Culture. CABI Publishing, Wallingford, UK, 2004. (3) P. L. Lentz. Am. Midl. Nat. 67:184, 1962. (4) L. Pan et al. J. Changjiang Vegetables (in Chinese) 14:10, 2010.

First Report of Leaf Spot of Houttuynia cordata Caused by Alternaria alternata in China

Houttuynia cordata is a perennial herbaceous plant (family Saururaceae) that is native to southern China, Japan, Korea, and Southeast Asia where it grows well in moist to wet soils. It is commonly used as a Chinese herbal medicine and as a vegetable. In North America and Europe it is also used as an ornamental. From September 2007 to November 2009, symptoms of leaf spot were found on H. cordata leaves in Dangyang County, Hubei, China, with the crop area affected estimated to be over 600 ha per year. Rhizome yield was reduced by 20% on average, with up to 70% yield losses in some fields during the autumn growing season. Lesions were initially small, brown, and oval or circular that developed into dark spots and sometimes formed target spots with white centers. These spots enlarged and overlapped, extending until the leaves withered entirely usually within 2 months. A fungus was consistently recovered from symptomatic leaf samples collected in October 2008 or 2009 with an average 90% isolation rate from ~60 leaf pieces that were surface sterilized with 0.1% mercuric chloride solution. Three isolates, HCDY-2, HCDY-3, and HCDY-4, were used to further evaluate characteristics of the pathogen. On potato dextrose agar, all cultures initially developed white colonies and the centers turned gray or brown after 4 days of incubation. Conidiophores were single or fasciculate, straight or knee curved, gray-brown with regular septa, and 42 to 61 × 4 to 5 μm. Conidia were obclavate or ovate, brown, and 26 to 38 × 12 to 20 μm with three to five transverse and one to three longitudinal or oblique septa. The tops of some conidia developed into secondary conidiophores, which were cylindrical, beige, and 5 to 17 × 3 to 5 μm. The pathogen was identified as Alternaria alternata based on descriptions in Simmons (3). Genomic DNA of HCDY-2 was extracted, and the rDNA-internal transcribed spacer sequence showed 99.6% identity to A. alternata (GenBank No. AY513941). Pathogenicity tests were performed with the three isolates by spraying conidial suspensions (1 × 10⁶ conidia/ml) containing 0.1% Tween 20 onto upper and lower surfaces of leaves of 40-day-old 15-cm high plants. There were 20 leaves from five replicate plants for each isolate. Control plants were treated with sterilized water containing 0.1% Tween 20 only. All plants were incubated with a 16-h photoperiod at 25°C and 90% relative humidity in an artificial climate chamber. Five days after inoculation, typical brown spots were observed on all inoculated leaves but no symptoms were seen on water-treated control plants. Koch's postulates were fulfilled by reisolation of A. alternata from diseased leaves. The pathogenicity tests were carried out twice. A survey of the literature revealed only a few fungal diseases associated with H. cordata (1,2,4), including Phyllosticta houttuyniae, Pseudocercospora houttuyniae, Rhizoctonia solani, and Sclerotium rolfsii. Although A. alternata is a cosmopolitan plant pathogen, it has not been reported on any species in the four genera in Saururaceae (Anemopsis, Gymnotheca, Houttuynia, and Saururus) (3). To our knowledge, this is the first report of A. alternata infecting H. cordata worldwide. References: (1) Y. L. Guo and W. X. Zhao. Acta Mycol. Sin. 8:118, 1989. (2) K. Sawada. Spec. Publ. Taiwan Univ. 8:138, 1959. (3) E. G. Simmons. Alternaria: An Identification Manual. The American Phytopathological Society, St. Paul, MN, 2007. (4) Y. Wu et al. J. Changjiang Vegetables (In Chinese) 2:19, 2007.

Impact of clinical condition at restarting dialysis on outcome after kidney allograft loss: a single-center experience

BACKGROUND

The purpose of this paper was to determine the impact of the clinical condition of the patient at the restart of dialysis on long-term survival after renal graft loss.

METHODS

We performed an analysis of 110 patients with renal allograft failure compared with 115 hemodialysis patients without kidney transplantation.

RESULTS

There was a relatively high glomerular filtration rate, low serum albumin, and greater prevalence of infection among graft loss patients compared with the never-transplanted patients. Patient survival after allograft loss was significantly lower than that of never-transplanted patients (P = .024) with 63.4% patients succumbing in the first 3 months. Serum hepatitis B virus (HBV) positivity, cardiovascular disease (CVD) and malnutrition were independent risk factors for graft loss patient upon COX regression analysis.

CONCLUSIONS

Serum HBV positive, complicated with CVD and malnutrition were independent risk factors for the graft loss among patients who restarted hemodialysis. More attention should be paid to treat complications of transplant recipients in K/DOQI 4 and 5 stages.

Stapler vs suture closure of pancreatic remnant after distal pancreatectomy: a meta-analysis

BACKGROUND

Suture closure and stapler closure of the pancreatic remnant after distal pancreatectomy are the techniques used most often. The ideal choice remains a matter of debate.

METHODS

Five bibliographic databases covering 1970 to July 2009 were searched.

RESULTS

Sixteen articles met the inclusion criteria. Stapler closure was performed in 671 patients, while suture closure was conducted in 1,615 patients. The pancreatic fistula rate ranged from 0% to 40.0% for stapler closure of the pancreatic stump and from 9.3% to 45.7% for the suture closure technique. There were no significant difference between the stapler and suture closure groups with respect to the pancreatic fistula formation rate (22.1% vs 31.2%; odds ratio, .85; 95% confidence interval, .66-1.08), although there was a trend toward favoring stapler closure. In 4 studies including 437 patients, stapler closure was associated with a trend (not statistically significant) toward a reduction in intra-abdominal abscess (odds ratio, .53; 95% confidence interval, .24-1.15).

CONCLUSIONS

No significant differences occur between suture and stapler closure with respect to the pancreatic fistula or intra-abdominal abscess after distal pancreatectomy, though there is a trend favoring stapler closure.

Hydroxyethyl starch 130/0.4 exerts its anti-inflammatory effect in endotoxemic rats by inhibiting the TLR4/NF-kappaB signaling pathway

Previous studies demonstrated that hydroxyethyl starch (HES) down-regulates the inflammatory response, but the mechanism is controversial. The present study measured the effects of HES130/0.4 on plasma proinflammatory cytokines levels and the Toll-like receptor-4 (TLR4)/nuclear factor-kappa B (NF-kappaB) signaling pathway in lipopolysaccharide (LPS)-treated rats. Endotoxemia was induced in rats by injection of LPS (5 mg/kg, via tail vein) and the rats were infused with different doses of HES130/0.4 (7.5, 15, or 30 ml/kg, via jugular vein). At 2 hr after the injection of LPS, plasma and peripheral monocytes were collected to determine tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta concentrations (enzyme-linked immunosorbent assay), NF-kappaB activities (electrophoretic mobility shift assay), TLR4 mRNA expression (reverse transcription-polymerase chain reaction), and TLR4 protein levels (Western blotting). The infusion of HES130/0.4 in endotoxemic rats, especially 15 ml/kg, significantly reduced the release of plasma TNF-alpha and IL-1beta, which was consistent with the observed inhibitory effects of HES130/0.4 on NF-kappaB activation, TLR4 mRNA expression, and TLR4 protein level in monocytes. Thus, HES130/0.4 evidently exerts its anti-inflammatory effect in endotoxemic rats by inhibiting the TLR4/NF-kappaB signaling pathway, which suggests that HES130/0.4 may useful for treating early Gram-negative sepsis.

Correlations of the stability, static dipole polarizabilities, and electronic properties of yttrium clusters

Static dipole polarizabilities for the ground-state geometries of yttrium clusters (Yn, n < or = 15) are investigated by using the numerically finite field method in the framework of density functional theory. The structural size dependence of electronic properties, such as the highest occupied molecular orbital-lowest occupied molecular orbital (HOMO-LUMO) gap, ionization energy, electron affinity, chemical hardness and softness, etc., has been determined for yttrium clusters. The energetic analysis, minimum polarizability principle, and principle of maximum hardness are used to characterize the stability of yttrium clusters. The correlations of stability, static dipole polarizabilities, and electronic properties are analyzed especially. The results show that static polarizability and electronic structure can reflect obviously the stability of yttrium clusters. The static polarizability per atom decreases slowly with an increase in the cluster size and exhibits a local minimum at the magic number cluster. The ratio of the mean static polarizability to the HOMO-LUMO gap has a much lower value for the most stable clusters. The static dipole polarizabilities of yttrium clusters are highly dependent on their electronic properties and are also partly related to their geometrical characteristics. A large HOMO-LUMO gap of an yttrium cluster usually corresponds to a large dipole moment. Strong correlative relationships of the ionization potential, softness, and static dipole polarizability are observed for yttrium clusters.

Depression, anxiety and quality of life in parents of children with epilepsy

OBJECTIVES

To assess the impact of childhood epilepsy on parental quality of life (QOL) and psychological health, and to investigate possible correlations between parental QOL and background variables as well as parental anxiety and depression.

SUBJECTS AND METHODS

Parents having an epileptic child (n = 263) and parents having a healthy child (n = 270) were enrolled. Groups were in balance for background variables. Short-Form Health Survey (SF-36) Questionnaire, Zung Depression Scale (ZDS) and Zung Anxiety Scale (ZAS) were applied to all parents. Patients were divided into the first visit group (newly diagnosed epilepsy) and follow-up visit group.

RESULTS

The parents of children with epilepsy had significantly lower QOL scores in SF-36 for all subscales and higher levels of depression and anxiety by using ZDS and ZAS. The factors correlated with parental QOL were seizure control, visit status, anxiety, depression, employment, cost of epilepsy, status epilepticus, drug side effect and age of parents.

CONCLUSIONS

Childhood epilepsy has a severe impact on parental QOL and psychological health, and recognition of possible correlations between parental QOL and background variables will be helpful to improve parental QOL.

(9S,13R,14R)-7,8-Didehydro-3,4,7-trimeth-oxy-17-methyl-morphinan-6-one

The title compound, C₂₀H₂₅NO₄, was synthesized by a Mitsunobu reaction of sinomenine [(9S,13R,14R)-7,8-didehydro-4-hydroxy-3,7-dimethoxy-17-methylmorphinan-6-one] with methanol. The chiral centers were unchanged during the reaction. Intra­molecular C—H⋯O hydrogen bonds result in the formation of six-membered rings.

An Outbreak of Head Rot of Cabbage Caused by Rhizoctonia solani AG2-1 in Central China

In July of 2007, an outbreak of head rot of cabbage (Brassica oleracea) occurred on more than 2,500 ha in Changyang County, Hubei Province, China. On average, yields were reduced by approximately 50%. Affected plants were first observed in 2006, and symptoms were considered physiological or nutritional disorders by growers. In 2007, the more extensive summer rains favored an increase in disease severity. Initial symptoms consisted of irregular, brown-to-black lesions on leaves and sometimes a wet decay of the base of outer leaves. Lesions expanded until entire heads were rotted. Rhizoctonia solani was recovered consistently from symptomatic plant tissues. Five isolates were used to evaluate cultural and morphological characteristics of the pathogen. On potato dextrose agar (PDA), all isolates yielded colonies that became brown after 5 days of incubation. The hyphae, 4.9 to 8.0 μm in diameter, branched at right or acute angles near the septa and each cell usually had six to eight nuclei. Dark brown sclerotia, 0.5 to 5 mm in diameter, appeared after 10 days of incubation. Genomic DNA of a representative isolate, CY-1, was extracted, and the rDNA-internal transcribed spacer sequence showed 99.5% identity to R. solani AG2-1 (Accession No. EU513147) in GenBank. Pathogenicity tests were completed in the laboratory by placing 6-mm-diameter mycelial plugs from 3-day-old PDA cultures of the five isolates onto 30 cabbage leaves detached from 5-week-old cabbage plants. The inoculated leaves were incubated at 28°C with 95% relative humidity in a controlled environment chamber. Two days after inoculation, black, wet lesions were observed on all inoculated leaves, while no symptoms were apparent on leaves inoculated with noncolonized PDA plugs. Koch's postulates were fulfilled by reisolating R. solani from diseased leaves. R. solani AG1 (1), AG2-1 (2), and AG4 (4) have been reported as causal agents of diseases of cabbage and related plants, and AG2-1 has been previously isolated from cabbage grown in southwest China (3), but to our knowledge, this is the most severe outbreak reported from China. References: (1) G. S. Abawi and S. B. Martin. Plant Dis. 69:158, 1985. (2) L. Corazza et al. Eur. J. Plant Pathol. 101:341, 1995. (3) H. R. Li and H. H. Zhu. J. Yunnan Agric. Univ. 3:247, 1993. (4) G. H. Yang et al. Plant Pathol. 56:351, 2007.

1-(1,3-Benzodioxol-5-yl)butan-1-one

In the mol-ecule of the title compound, C(11)H(12)O(3), the dioxole ring adopts an envelope conformation. In the crystal structure, weak inter-molecular C-H⋯O hydrogen bonds link the mol-ecules into chains.

Early initiation of tacrolimus or cyclophosphamide therapy for idiopathic membranous nephropathy with severe proteinuria

BACKGROUND

Early initiation of therapy is warranted for patients with idiopathic membranous nephropathy (IMN) who have severe proteinuria. Therapy with tacrolimus (TAC) or intravenous cyclophosphamide (CYC) may be an option in treating such patients.

METHODS

This prospective cohort study included patients with IMN whose daily proteinuria was greater than 6.0 g with 3-6 months observation of nonimmunosuppressive therapy. One cohort received prednisone combined with oral TAC (target trough blood level of 4-8 ng/mL) for 24 weeks. The other cohort received prednisone combined with intravenous CYC (750 mg/m2 body surface) every 2 weeks for the first 8 weeks and then once per 4 weeks for the next 16 weeks.

RESULTS

Thirty patients met criteria for enrollment, and 25 patients completed therapy. The results of the 24-week therapeutic period were complete remission (CR) 4 patients (30.8%) on CYC and 8 patients (66.7%) on TAC; partial remission (PR) 7 patients (53.8%) on CYC and 3 patients (25%) on TAC; no response 2 patients (15.4%) on CYC and 1 patient (8.3%) on TAC. The percentages of remission (either PR or CR) by 4 and 8 weeks were significantly higher in TAC group than in CYC group (p<or=0.05). The probability of CR was significantly higher in the TAC group than in the CYC group (p=0.018, by log-rank test).

CONCLUSION

Earlier initiation of therapy with TAC or intravenous CYC (combined steroid) for 24 weeks was useful for Chinese adults with IMN in inducing remission of severe proteinuria, and quicker remission was seen in TAC therapy.

Ghrelin improves delayed gastrointestinal transit in alloxan-induced diabetic mice

AIM: To investigate the effects of ghrelin on delayed gastrointestinal transit in alloxan-induced diabetic mice.

METHODS: A diabetic mouse model was established by intraperitoneal injection with alloxan. Mice were randomized into two main groups: normal mice group and diabetic mice group treated with ghrelin at doses of 0, 20, 50, 100 and 200 &mgr;g/kg ip. Gastric emptying (GE), intestinal transit (IT), and colonic transit (CT) were studied in mice after they had a phenol red meal following injection of ghrelin. Based on the most effective ghrelin dosage, atropine was given at 1 mg/kg 15 min before the ghrelin injection for each measurement. The mice in each group were sacrificed 20 min later and their stomachs, intestines, and colons were harvested immediately. The amount of phenol red was measured. Percentages of GE, IT, and CT were calculated.

RESULTS: Percentages of GE, IT, and CT were significantly decreased in diabetic mice as compared to control mice (22.9 ± 1.4 vs 28.1 ± 1.3, 33.5 ± 1.2 vs 43.2 ± 1.9, 29.5 ± 1.9 vs 36.3 ± 1.6, P < 0.05). In the diabetic mice, ghrelin improved both GE and IT, but not CT. The most effective dose of ghrelin was 100 &mgr;g/kg and atropine blocked the prokinetic effects of ghrelin on GE and IT.

CONCLUSION: Ghrelin accelerates delayed GE and IT but has no effect on CT in diabetic mice. Ghrelin may exert its prokinetic effects via the cholinergic pathway in the enteric nervous system, and therefore has therapeutic potential for diabetic patients with delayed upper gastrointestinal transit.

Ultrastructural changes, nuclear factor-kappaB activation, and tumor necrosis factor-alpha expression in brain after acute normovolemic hemodilution and controlled hypotension in rats

AIM

To examine brain damage following different degrees of acute normovolemic hemodilution combined with controlled hypotension (ANH-CH) by neuronal morphological analysis and investigate the expression of nuclear factor-kappa B (NF-kappaB) activity and tumor necrosis factor-alpha (TNF-alpha) in the rat.

METHODS

Forty rats were randomly assigned to receive a sham operation or ANH-CH (with hematocrit 30%, 25%, 20%, and 15%). ANH was performed after baseline physiological parameters had been monitored for 20 minutes. CH was induced 30 minutes later using sodium nitroprusside and mean arterial pressure was maintained at 50-60 mm Hg for 1 hour. Rats were euthanatized 3 and a half hours after operation. TNF-alpha levels and NF-kappaB activities in cerebral temporal cortex were measured. Ultrastructural alterations in the CA1 region of the rat hippocampi were observed. Changes in mitochondria were evaluated semiquantitatively.

RESULTS

Marked ultrastructural alterations, such as mitochondrial denaturalization and nucleus distortion, were observed in the CA1 region of the hippocampus in the ANH-CH hematocrit 20% group and ANH-CH hematocrit 15% group. TNF-alpha expression and NF-kappaB activity in the cerebral temporal cortex significantly increased in all ANH-CH groups and peaked in the ANH-CH hematocrit 25% group.

CONCLUSION

Severe ANH-CH with hematocrit < or =20% may induce cerebral damage and should be avoided. NF-kappaB activation and TNF-alpha expression may play a functional role under the ischemic condition. A better understanding of the role of NF-kappaB and TNF-alpha in the brain may lead to a novel approach for preventing and treating various neurological disorders.

Brain damage following severe acute normovolemic hemodilution in combination with controlled hypotension in rats

BACKGROUND AND AIM

The reduced oxygen content and perfusion pressure during acute normovolemic hemodilution (ANH) and controlled hypotension (CH) raise concerns about hypoperfusion and ischemic injury to the brain. In this study on rats, we examined the brain damage following four different degrees of ANH combined with CH.

METHODS

Forty rats were randomly assigned to receive a sham operation or CH and ANH [with a hematocrit (Hct) of 30, 25, 20 or 15%]. ANH was performed after baseline physiological parameters had been monitored for 20 min; 30 min later, CH was induced using sodium nitroprusside, and the mean arterial blood pressure was maintained at 50-60 mmHg for 1 h. Rats were killed 3.5 h after hemodilution. Ultrastructural alterations in the CA1 region of the rat hippocampus were observed, and serum concentrations of S100B and neuron-specific enolase (NSE) were measured before and after ANH.

RESULTS

The serum S100B concentration increased significantly in the Hct 20% + CH and Hct 15% + CH groups. However, there were no significant differences in the serum levels of NSE between the groups. In the CA1 region of the rat hippocampus, marked ultrastructural alterations, such as mitochondrial denaturalization and nucleus distortion, were observed in the Hct 20% + CH and Hct 15% + CH groups.

CONCLUSION

Severe ANH (Hct < or = 20%) combined with CH may induce cerebral damage, as confirmed by marked ultrastructural alterations in the CA1 region of the rat hippocampus and significantly increased serum levels of S100B, and should be avoided.

Regulation of adipose-derived adult stem cells differentiating into chondrocytes with the use of rhBMP-2

BACKGROUND

Adipose tissue has been demonstrated to contain a population of progenitor cells that can differentiate into bone and cartilage. Studies have suggested that adipose-derived adult stem (ADAS) cells can be induced to differentiate into chondrocytes by transforming growth factor-beta (TGF-beta). In this study, we examined whether bone morphogenetic protein-2 (BMP-2), as a member of the TGF-beta superfamily, could regulate ADAS cells to differentiate into a chondrolineage.

METHODS

ADAS cells were isolated and induced by rhBMP-2. These cells were cultured in pellets for 2 weeks, and the chondrogenic phenotype was observed in vitro and in vivo. ADAS cells cultured without BMP-2 were used as controls.

RESULTS

After 2 weeks of culture, the differentiated ADAS cells reacted positively to Alcian blue and collagen II, and the content of collagen II protein was obviously up-regulated at day 14. Glycosaminoglycan (GAG) content gradually increased from day 2 to day 14 (P < 0.05). However, H&E staining and collagen II expression were weak, and there was a little collagen II protein and GAG detected in the control group. Additionally, the pellets of ADAS cells induced by rhBMP-2 were transplanted into BALB/C nude mice and formed cartilage lacuna at week 8 in vivo.

DISCUSSION

These data demonstrate that rhBMP-2 induce ADAS cells to differentiate into chondrocytes in vitro and in vivo. This is useful for basic and clinical studies aimed at repairing cartilage damage. But in a control group, ADAS cells tended towards differentiation into chondrocytes, which was affected by ITS. We will be exploring the mechanism further.

Hydroxyethyl starch exhibits antiinflammatory effects in the intestines of endotoxemic rats

We performed the present in vivo study to investigate the effect of hydroxyethyl starch (HES) on intestinal production of inflammatory mediators and activation of transcription factors during endotoxemia. Rats with endotoxemia induced by lipopolysaccharide (LPS) (5 mg/kg, IV) were treated with HES (16 mL/kg, IV) or saline (64 mL/kg, IV). At 2, 3, or 6 h after the LPS challenge, the rat ileal tissues were collected. Various ileal inflammatory mediator levels (tumor necrosis factor-alpha, interleukin [IL]-6, cytokine-induced neutrophil chemoattractant-1, and IL-10), inflammatory mediator messenger RNAs (mRNAs), activities of nuclear factor (NF)-kappaB and activator protein (AP)-1, and ileal myeloperoxidase-positive cells were determined in each group. HES significantly reduced the increased intestinal levels of tumor necrosis factor-alpha, IL-6, cytokine-induced neutrophil chemoattractant-1, and the mRNAs in the endotoxemic rats. Similarly, HES could decrease the myeloperoxidase-positive cells induced by LPS and also inhibit ileal NF-kappaB and AP-1 activations. Our results suggest that during endotoxemia HES may down-regulate intestinal inflammatory mediator production, and this antiinflammatory effect of HES may act through suppression of NF-kappaB and AP-1 activations.

Pentoxifylline decreases up-regulated nuclear factor kappa B activation and cytokine production in the rat retina following transient ischemia

AIM

To investigate whether pentoxifylline (PTX) could influence the increased cytokine gene expression in the retina flowing transient ischemia, and if so, whether it acts through the modulation of nuclear factor kappa B (NF-kappaB) activation.

METHODS

Sprague-Dawley rats were randomly divided into three equal groups: control group, saline-treated group, and PTX-treated group. Increased intraocular pressure was applied for 90 min to induce retinal ischemia, and reperfusion was established by lowering the bottle to eye level. The reperfusion period lasted for 48 h. In the PTX-treated group, an initial dose of 20 mg PTX was injected via tail vein at the beginning of reperfusion. Then the rat received infusion of PTX at a rate of 6 mg/kg/h throughout the entire reperfusion period. The retinal tissues were collected at the end of 1, 6, 12, 24, and 48 h of reperfusion, respectively, for biochemical analysis. Histological examination was done on the tissues collected at the end of 48 h after reperfusion.

RESULTS

Histological examination revealed reduction of overall retinal thickness and thinning of the inner retinal layer in saline-treated rats after 48-hour reperfusion. However, PTX treatment significantly reduced the loss of overall retinal thickness and thinning of inner retinal layers. Dramatic increase in NF-kappaB activation, tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) production and mRNA expression were observed in the saline-treated group after reperfusion, with the peak reached around 12 h. In the PTX-treated group, NF-kappaB activation, TNF-alpha and IL-1beta production and mRNA expression were significantly reduced at each corresponding time point compared to the saline-treated group.

CONCLUSION

PTX decreased the up-regulated activation of NF-kappaB and the expression of proinflammatory cytokines, TNF-alpha and IL-1beta in rat retinas following ischemia/reperfusion. This may contribute to significantly reduce the loss of overall retinal thickness and thinning of inner retinal layers.

Betamethasone affects cerebral expressions of NF-kappaB and cytokines that correlate with pain behavior in a rat model of neuropathy

The objective of this study was to investigate whether corticosteroids modulate neuropathic pain by altering cerebral expression of nuclear factor-kappa B (NF-kappaB) and specific cytokines. The effects of topical betamethasone on neuropathic pain and cerebral expression of NF-kappaB and cytokines were studied in a rat model of L5 spinal nerve transaction. Behavioral testing was undertaken on days 1, 3, 7, 14, and 21 post-operation using the von Frey and Hargreaves tests. NF-kappaB activation in the brain was investigated by an electrophoretic mobility shift assay (EMSA), and cerebral expressions of tumor necrosis factor-alpha (TNFalpha), interleukin-1beta (IL-1beta), and interleukin-10 (IL-10) were quantified using enzyme-linked immunosorbent assays (ELISA). Spinal nerve transection induced mechanical allodynia and thermal hyperalgesia, which were significantly ameliorated by topical injection of betamethasone around the site of injury. In addition, betamethasone reduced the activation of NF-kappaB and elevation of TNFalpha and IL-1beta, and induced the expression of IL-10 in the brain, all of which correlated with the changes of pain thresholds in rats. The results suggest that topical betamethasone injection inhibits the development and maintenance of neuropathic pain. Betamethasone may act by regulating the expression of NF-kappaB, TNFalpha, IL-1beta and IL-10 in the brain. This study yields new insight into the mechanisms of corticosteroid action in neuropathic pain and may provide a basis for clinical pain control.

The Impact of Pretransplant Cytomegalovirus Infection on Acute Renal Allograft Rejection

BACKGROUND

The role of cytomegalovirus (CMV) infection in renal allograft rejection remains controversial; moreover, there are few studies on pretransplant infections. This study sought to investigate whether pretransplant CMV infections had negative effects on acute rejection episodes (ARE) and to evaluate the effect of preemptive treatment.

METHODS

This retrospective single-center study of 416 transplant recipients from October 1, 2000 to September 1, 2003 had CMV infections diagnosed by CMV antigenemia tests. The incidences of ARE were compared between CMV-infected and noninfected groups. Risk factors for ARE were analyzed. Based on preemptive treatment, pretransplant CMV-infected recipients were divided into ganciclovir-treated and nontreated groups and the incidence of ARE was compared between the two groups.

RESULTS

One hundred eighty four recipients had CMV infections pretransplant; the infection rate was 44.2%. Fifty five recipients had ARE among the pretransplant CMV-positive group, which was significantly higher than that in the noninfected group (29.9% vs 19.5%, P = .014). But the rejection subgroups and renal function recovery had no significant differences. While the presence of pretransplant infection was an independent predictor of ARE (RR = 1.807), severity showed no significant impact on ARE. Among 184 pretransplant CMV infection recipients, the incidences of ARE were 14.3% and 18.0% in ganciclovir-treated versus nontreated patients, respectively (P = .650).

CONCLUSIONS

Pretransplant CMV-positive recipients were at greater risk of ARE. Pretransplant CMV infection was an independent risk factor for ARE. Preemptive antiviral treatment did not show protective effects against ARE related to CMV infection-mediated immunological injuries.

Effects of hydroxyethyl starch on hepatic production of cytokines and activation of transcription factors in lipopolysaccharide-administered rats

BACKGROUND

Hydroxyethyl starch (HES) is one of the most frequently used plasma substitutes. Some studies have indicated that HES may have anti-inflammatory effects. The present in vivo study was performed to investigate the effects of HES on hepatic production of cytokines and activation of transcription factors in sepsis.

METHODS

Adult male Sprague-Dawley rats were randomly divided into four groups: rats challenged with lipopolysaccharide (LPS) (5 mg kg(-1)) and treated with saline (64 ml kg(-1)); challenged with LPS (5 mg kg(-1)) and treated with HES (16 ml kg(-1)); injected with saline and treated with HES (16 ml kg(-1)); and saline control. Each hepatic tissue was collected in groups of rats 2 h after induction of endotoxemia for determination of tumour necrosis factor (TNF)-alpha levels, TNF-alpha mRNA expressions, and nuclear factor (NF)-kappaB, activator protein (AP)-1 activities or 3 h after LPS challenge for IL-1beta, IL-6, IL-8, IL-10 levels and the mRNA expressions.

RESULTS

Endotoxemia was associated with significant increases in hepatic proinflammatory cytokine productions and transcription factor activities. HES significantly reduced the increased hepatic levels of TNF-alpha, IL-1beta, IL-6, IL-8 and the mRNAs in the endotoxemic rats. Similarly, HES could inhibit hepatic NF-kappaB and AP-1 activations.

CONCLUSION

The results suggest that in sepsis HES may down-regulate hepatic inflammatory mediators production and these anti-inflammatory effects may act through inhibition of NF-kappaB and AP-1 activations.